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Hurricane Katrina hit the United States of America especially New Orleans displacing people as well as causing huge destructions. Although all these can be observed, one thing that passes the eyes and concern of many is the issue of stress to nurses who strive to save the lives of the victim. The study seeks to establish the various kind of stress nurses undergo during and after the whole incident. A theory is also developed in trying to guide the plan of addressing how such stress can be handled and create a lasting solution since the mental and physical stress the medical professions undergo has seen to it that the number of these profession have declined tremendously in the recent past. This is in no doubt a worrying trend in the country.
Hurricane Katrina categorized as category 4 storm swept the United States of America in August 2005 leading to serious consequences in the recent past in American history. Katrina together with he flooding that came with it so it that close to a half a million individuals were evacuated. Similarly, properties were destroyed; of significance were health facilities as well as its resources. In the quest of trying to offer medical attention to citizens, the states and the federal government sent health care professional. These individuals faced a myriad of challenges that proved stressful in their lives (Weems, 2007). The numbers of nurses were few compared to that seeking medication assistance and due to unpredictability and controllability of the situation, a number of nurses experienced stress.
It is worth mentioning that although nurses are fully aware of their role during disaster as they have taken leadership role in addressing the problems at hand the issue of stress facing a number of them might be a serious set back. According to McGowan, 2001 stress comes to light when an individual is faced with issues deemed to negatively impact on their physical and mental state. Levels of stress usually increases when controllability and predictability declines which in most cases is when disasters occurs. It is established that when such levels increases, there is a sharp decline in nurses’ satisfaction and motivation.
This could possibly lead to medical professional to leave resulting to shortages of nurses, poor medical services to citizens/victims of a disaster among others. It is evident that the phenomenon is on the rise and if preventive measures are not taken into consideration citizens will lack adequate medical attentions in the wake of natural disasters. Among the intervention to curb stress in nurses during natural disasters include preparing them psychologically of what they expect during such times, provide them with all equipment and moral support, adequately training them on how to handle stress, if possible remove potential stressors just to mention but a few.
The searchable question that guide the research is, “what are the sources and effects of stress to nurses after Hurricane Katrina” With the advance effects of the category 4 storm that negatively impacted economically, socially and environmentally, medical professionals especially nurses were called upon to provide healthcare services to the affected individuals. Despite the fact that all relevant stakeholders expect nurses to offer the desired and expected services, it is worth noting that a time the call is very challenging which is echoed by Hingley that. Everyday the nurse confronts stark suffering, grief and death as few other people do. Many nursing tasks are mundane and unrewarding. Many are, by normal standards, distasteful and disgusting. Others are often degrading; some are simply frightening.
Very few individuals appreciate these important points. In most instances, there are various situations whereby the nurses can do very little especially due to lack of enough resources, inaccessibility, inadequacy in their numbers among other issues. For instance, failures of machine, power shortages, and lack of medicine leave the nurses with no option but to comfort patient waiting for death if help won’t come on time. According to Dr. Wash, the situation faced by nurses was similar to what wounded soldiers faced in “Gone With the Wind” as nurses were just standing giving patients food and water, he says that the situation was like back in 1800 where there was no modern medicine.
With all these problems, nurses are not only physically stress in the desire to reach and help individuals who are in unreachable areas but also psychologically suffer by seeing patients serious suffer and die due to lack of adequate facilities to avert this. The implications of such stress is low morale and high rate of dissatisfaction that translates to poor medical service delivery, high level of death and eventually loss of interest in the profession leading to nurses shortages that might negatively affect the health sector in the near future.
Nursing stress is a common problem that has stricken the nursing profession over the years. This has turned to be fatal especially when nurses are faced by a situation or an event that endanger their lives as well as the lives of the people they are working on in the hospital either physically or psychologically. Stress is seen to increase in a situation where the level of the cause seems not to abate but otherwise get to uncontrollable and unpredictable situation as the case of Hurricane Katrina. When the stress gets to this position, it results to decreased job quality and satisfaction in life. This can make the nurse to quit their profession in future due to the stress that is attached therein making the field to have deficit in personnel.
The cause of the stress in the nursing field is mostly caused by the circumstances that they are put into in their execution of their duties. In the case of Hurricane Katrina there were things that they were supposed to do whose decision were too simple to make at the first instance. Such decision as evacuating patient who had of recent undergone surgery, fresh born babies among other delicate issues made the nurses in New Orleans.
Statement of the problem
During the time when Hurricane Katrina struck New Orleans in August 2005, hospitals were the most vulnerable as they required a fast an reliable means of evacuating those people who were in hospital. These required a well-planned logistic method as the hospital facilities were few in other places due to the over population. The nurses were in a great dilemma after the mayor of New Orleans town announced a compulsory evacuation on Saturday after it became clear that the hurricane would hit the town. The transport system was few and due to the number of the patients in other hospital, there were no enough facilities to take care of them.
Therefore, this created a stressful condition whereby the patients must be evacuated, but most of the hospitals were reluctant to do so. There was also other critical condition that the nurses had to think about them. Such situations were like cases of newly born babies and freshly operated patients who were in the process of healing their wounds. Some of the transportation mechanism of such patients contravened their ethical norms as such could cause death on the way. On the contrary, they had to obey the legal order that was given or otherwise they were to perish under the wrath of Hurricane Katrina (Weeks, 2007).. This is one of major stress situation that the nurse had to endure as they were supposed to ensure that they support the patients during this time.
The situation at that time was urgent for the hospital as the Hurricane destroyed the power, cut down the communication lines, damaged water and the sewerage systems and it was very hard to supply such facilities as drugs for the patients, blood for transfusion process during emergences, linens and food. This was great stress for the nurses as they were supposed to make very vital decision on the distribution of the available resources among the bulged number of the patients in the hospital. Therefore, no matter how much they wanted to keep encompassed in their work ethics, they had to break some to salvage the live of the people.
Stress caused to nurses during Hurricane Katrina
The nurses operating in the hospitals were stricken by dilemma as the calamity approached. They understood very well that Katrina was a great storm that had ability to cause fatal destruction. It cause was undefined and they were uncertain of what was to happen in the hospital services having survived numerous storms that reigned before. According Schroeter 2009, a place like Charity hospital, the officials claimed that they did not consider evacuation at the first instance as it had been the one that was previously used to during the time of major storm. It housed among the vital amenities to cater for catastrophic events like Hurricane Katrina thus making the hospital official to feel that they should not evacuate. This was the greatest stress that the management had in making the decision. This is because they were supposed to know whether to evacuate the patient or not even after the town mayor announced the New Orleans would be affected.
The nurses in the hospital in these places were very much affected. They were turn between job and salvaging of their lives and their patients. However, some of the hospital management decided on the evacuation process. The main problem was to decide who were to use the meager transportation ambulances that were within the hospitals reach. The other thing was the time it was to take to ensure that the unpredicted approaching hurricane never found them in the process. The delicate issue that was to be involved in the transportation of the patient safely was another stressful issue in the nursing fraternity. Finally, the place where these patients were to be kept remained to be one of the thorny issues in a number of hospitals that had no otherwise apart from evacuating their patients. The nurses could not have wanted the patient to die under their own hands so; they had to be fast in decision-making.
Most of the hospitals in New Orleans discharged stable patients prior to the hurricane using the available ambulances. The patients in the Intensive Care Unit in some hospital were to be transferred prior to the Hurricane Katrina strike but there were no place for them to be evacuated to. These led them being transferred to other hospitals where were subsequently surrounded by floodwater. This was one among nursing stress as their lives were also in danger.
Now, the problem that was on the nurses neck was the where these patients were to be taken. Critically ill patients were supposed to be transported for a short distance to ensure that they are able to arrive there safely. However, the Hurricane was unpredictable it would had effect to what distance from the town. This was a problem for the nurse to give solution depending on their career ethics that postulate that nurses are supposed to help the patients in their condition receive the most appropriate service to ensure that they recover from their situation (Weems et al. 2007).
According to Todd, 2005, nurse stresses were not over even if they could have been able to evacuate the patients. This is because due to the urgency of the matters, it was not clear what course of action that they could have taken after that. The problem was about the patients who were disoriented and the one who were respirators and the tractions. The condition outside the hospital was not favorable for their evacuation and it would have may be lead to their death. Most of the hospitals management believed that the patients who were in critical condition would be endangered to be transported in hasty evacuation. This may lead to death or deterioration of their condition considering the traffic that was there as all the people were evacuating. They were in dilemma on their safety in the hospital and at any other place. This made most of the nurses to succumb stress that were beyond their limits.
Lazarus Theory of psychological stress
According to Antonovsky 1979, Lazarus Theory of psychological stress can explain stress in the nursing field as it was experienced during Hurricane Katrina. This theory has been taken as it covers the significance of once well being and the search of how to cope up with a situation that has adversely affected someone in pursuit of managing specific demands as in the case of Hurricane Katrina.
How theory works
This theory ensures that the person is able to recognize and understand stress relevant transaction. This means that the concept of this theory lay in the idea that emotional processes depend upon the expectancies that a person shows after an outcome of certain encounter as that of Hurricane Katrina. It can be understood through breaking it in two appraisals, primary and secondary.
In primary appraisal, there are there components that are put in place to ensure that they distinguish. The first element is goal relevance. This describes the extent to which a certain encounter refers to issues about how person cares. The second element is the goal congruence. This shows the extent to which a certain episode affects personal goals. The last element is the ego-involvement that shows once commitment towards self-esteem, moral values and ego identity.
The secondary appraisal has two components. These components are distinguished as credit and blame components. The two components results from the person questioning the person behind a certain event.
Conditions of the hospital after the Hurricane Katrina
After the hurricane, the hospitals were in very pathetic conditions. They were understaffed and the nurses were supposed to work for long hours. The nurses were working at very poor condition that made them to lower their productivity in the hospital. They even risked training family members to operate a hand driven machine that was used to pump air that was used by the patients that were in the intensive care unit. According Salzer & Bickman1999 in nurse ethics, this is one of the contrary measure but circumstances and the stress of their work capacity forced them to do so.
There was a lot of pressure in the hospitals as patients care was exceedingly difficult due to loss of power. The vital equipments in the hospital were not operable due to loss of energy. Equipment such as x-ray machine, dialysis and the elevators went to a standstill causing multiple deaths in the hospitals. These conditions found the nurse in places where they were not in a position to help the patients. It created a great stigma to the nurses as they stressed themselves to help the patient but were incapable. Some of the nurses were unable to continue with their jobs afterward due to stress that they succumb during that period.
The research ensures that it covers the way the hospitals were affected by the Hurricane Katrina and the stress caused in the process. It shows the disadvantages that underlay the evacuation order by exempting some people. For example, it will discuss the stress caused to the nurse due to evacuation exemption of people living in the cities, state and federal officials, inmates and those who were in hospitals, tourists and the media people.
Methods used in gathering information
The paper is based on several interviews that were done in a number of hospitals that were victims of the Hurricane Katrina. The interviews also were done to the trade association leaders who were in the forefront in helping the needy in that time of the calamity. The information was also gathered from public officials and other stakeholders who had first-hand experience of the devastation of the Hurricane Katrina. The materials wee also gathered from different journals that were written during and after Hurricane Katrina. The research collected information through also designing of questionnaire that was used to answer questions related to the stress issue in the nursing field during that time.
Population used in research
The researched covered a great part of the New Orleans hospital especially in the leadership level as they were the one entitled to give the required information about the happened. It also involved leaders from public officers who were able to give the information on how the government and the nation aid community helped especially in the evacuation process of the patients and the rehabilitation process of the most affected nurses due to what happened during that time. The other kind of the population that was put into consideration was the number of the journals and the articles that were used to refer on pictures and the information that the interviewed personnel could not either remember or were unable to give due to the emotions that the whole episode brought. Therefore, the research was intensive.
Strength of the research
Most of the information gotten was first hand as the interviews and the questionnaires were adversely used. It also involved different hospitals that were directly involved in the calamity. This ensured that we got good information that can be used for affirmative action towards reverting of the stress that the nurses succumbed in the Hurricane Katrina devastation.
Some of the information especially the number of death that happened during that period was still not able to be included as there was some investigation that was not completed already. There were some of the information that were contradictory in as given from the interviews and as written in the existing journals, so it took as more resources to harmonize them by doing more probing
Developing an Implementation Plan
To develop an implementation plan is useful in the view of the fact that there will be a reference point in monitoring the project. The implementation plan will ensure the project is run in an efficient and effective manner. It is useful to be able to settle on the time frame of the project; train and educate the providers of the services, and share all the roles and responsibilities among the actors in the project. In addition it is used to give formal and written objectives and referrals, communication protocols and the policies, rules and regulations. Above all it is very useful in gauging the performance of the project in a logical and rational way.
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